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Workers' Compensation and Employers' Liability Policy <br />Named Insured <br />TriNet Group, Inc. UC/P SOCRadar Cyber Intelligence, Inc. <br />Endorsement Number <br />1 Park Place, Suite 600 <br />Dublin, CA 94568-7983 <br />Policy Number <br />Symbol: WLR Number: CS7824748 <br />Policy Period <br />Effective Date of Endorsement <br />07/01/2024 TO 07/01/2025 <br />03/31/2025 <br />Issued By (Name of Insurance Company) <br />ACE American Insurance Company <br />Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. <br />This endorsement changes the policy to which It is attached and is effective on the date issued unless otherwise stated. <br />CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement applies only to the insurance provided by the policy because California is shown in item 3.A. of the <br />Information Page. <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not <br />enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to <br />bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to <br />obtain this waiver from us. <br />You must maintain payroll records accurately segregating the remuneration of your employees while <br />engaged in the work described in the Schedule. <br />Schedule <br />1. (X) Specific Waiver <br />Name of person or organization: <br />City of Santa Ana, and its City Council, its officers, officials, employees, agents, and volunteers <br />20 Civic Center Plaza <br />Ross Annex (N-22) <br />Santa Ana, CA 92701 <br />() Blanket Waiver <br />Any person or organization for whom the Named Insured has agreed by written contract to <br />furnish this waiver. <br />2. Operations: Project: #14-68091 Arterial Street Slurry Seal <br />3. Premium: <br />The premium charge for this endorsement shall be INCLUDED percent of the California premium <br />developed on payroll in connection with work performed for the above person(s) or organization(s) <br />arising out of the operations described. <br />4. Minimum Premium: INCLUDED <br />WC 90 03 75 (05/18) <br />